Provider Demographics
NPI:1053955013
Name:ZABALETA, LATRENDA CHARDE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LATRENDA
Middle Name:CHARDE
Last Name:ZABALETA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:LATRENDA
Other - Middle Name:CHARDE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:568 COMMUNIPAW AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-4402
Mailing Address - Country:US
Mailing Address - Phone:201-309-0198
Mailing Address - Fax:
Practice Address - Street 1:568 COMMUNIPAW AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-4402
Practice Address - Country:US
Practice Address - Phone:201-309-0198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-03
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00583400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist